Suchergebnisse

Legal protection provided support and certainty for practitioners or doctors in carrying out their jobs according to service standard, competence and authority. However, the general practitioners who were on duty in the emergency units (ERs), in performing emergency services, we are often instructed by a medical specialist through telephone talk to perform medical actions as needed by the patients. The authority delegation, from a medical specialist to a general practitioner, could factually be full of potential errors whereas there had not been any legislation regulating such authority delegation. Therefore, it would possibly raise ethical and legal accountability matters for the general practitioners caused by the authority transfer between the physicians.This legal research was qualitative research applying analytic descriptive and socio-legal studies approaches, so the discussion covered legal aspects beside social aspects about authority delegation between the two types of practitioners or doctors at ER. The data gathered were both primary and secondary data by involving general practitioners working at the ER of "Mitra Keluarga" Hospital and medical specialists of the same hospital. Besides, the data were also got from the Hospital Director and the Chairman of the Medical Committee.There was no legislation regulating authority delegation of medical specialists to general practitioners so that the internal rules of "Mitra Keluarga" hospital did not regulate such authority delegation. Likewise, legal protection to general practitioners of the ER of "Mitra Keluarga" hospital had not been regulated in detail within the internal rules of "Mitra Keluarga" hospital. However, such legal protection could be attributed to all policies issued by the hospital, such as labour and operational standards applicated in the hospital. The authority delegation from a medical specialist to a general practitioner working at the emergency unit could be matched by authorization as applicable in civil law. Ethically and legally, ...

Introduction : Indonesia is one of the countries with high Maternal Mortality Rate that result partially from in management inefficiency, causing in obstruction of flow, underutilized resources, and imbalance between the number of patients with the availability of care facilities and the alternative care strategies. One of the strategies that can be applied to reduce lead time is Lean Six Sigma (LSS). Therefore, the purpose of this study was to evaluate the impact of Lean Six Sigma (LSS) methodology on patient lead time in Maternal Emergency of district government hospital.Methods: Researcher and the participants were involved in planning, gathering data, analyzing, and choosing the best solutions. The participants were trained on LSS methods, its implementation tools and procedures. Evaluations were conducted using lead time observation before and after implementation, and midwives were interviewed about their perceptions. The analysis was based on Value Stream Mapping tools. Results: Patients' lead time from being admitted in emergency unit definitive diagnosis was decreased by 26.04 minutes or 16.4% in Caesarean Section (CS) and 15.25 minutes or 21.7% in other maternal high risk. For emergency CS, the improvement was 33.06 minutes or 26% from decision until incision. The benefit of LSS implementation was primarily in accelerating service processes and improving communication and team work. Conclusion: This study showed that the implementation of LSS had great potential benefit in a maternal emergency unit. Participation of the midwives is crucial for successful implementation of LSS to reduce patients lead time.